MINUTES OF THE MEETING OF THE
Haringey and Islington Health and
Wellbeing Boards Joint Sub-Committee HELD ON
MONDAY 9 October 2017 AT 2.00
pm.
PRESENT:
Cllr
Richard Watts, Leader of the Council, LB Islington
[Chair]
Cllr
Claire Kober, Leader of the Council, LB Haringey
[Vice-Chair]
Cllr
Janet Burgess, Executive Member for Health and Social Care, LB
Islington
Cllr
Joe Caluori, Executive Member for Children, Schools and Families,
LB Islington
Tony
Hoolaghan, Chief Operating Officer, Haringey and Islington Clinical
Commissioning Groups
Dr Jo
Sauvage, Chair, Islington Clinical Commissioning Group
Dr
Peter Christian, Chair, Haringey Clinical Commissioning
Group
Sorrel
Brookes, Lay Vice-Chair, Islington Clinical Commissioning
Group
Emma
Whitby, Chief Executive, Healthwatch Islington
Sharon
Grant, Chair, Healthwatch Haringey
Julie
Billett, Director of Public Health, LB Islington
Sean
McLaughlin, Corporate Director of Housing and Adult Social
Services, LB Islington
Tracie
Evans, Interim Deputy Chief Executive, LB Haringey
Jeanelle De Gruchy, Director of Public Health, LB
Haringey
Beverley Tarka, Director of Adult Social Care, LB
Haringey
Margaret Dennison, Interim Director of Children’s
Services, LB Haringey
ALSO PRESENT:
Helen
Taylor, Clinical Director and Deputy Director of Strategy,
Whittington Hospital
Rachel
Lissauer, Director of the Haringey and Islington Wellbeing
Partnership
Zina
Etheridge, Interim Chief Executive, LB Haringey
15
Filming at meetings
(Item 1)
Councillor Watts referred to information on the agenda and
members noted the guidance in respect of filming at
meetings.
16
Welcome and Introductions
(Item 2)
Councillors Watts and Kober welcomed everyone to the meeting and
the members of the Sub-Committee introduced themselves.
17
Apologies for Absence
(Item 3)
Apologies for absence were received from Councillor Weston,
Councillor Arthur, Dr Katie Coleman, Carmel Littleton, Angela
McNab, Cathy Herman, Geraldine Gavin, Geoffrey Ocen and Siobhan
Harrington (representative: Helen Taylor, Clinical Director and
Deputy Director of Strategy, Whittington Hospital).
18
Notification of Urgent Business
(Item 4)
There
were no items of urgent business to consider.
19
Declarations of Interest
(Item 5)
Dr Jo
Sauvage declared a personal interest as a GP provider in
Islington.
20
Minutes of the Previous Meeting
(Item 6)
RESOLVED:
That
the minutes of the previous meeting held on 19 June 2017 be agreed
and the Chair be authorised to sign them.
21
Questions and Deputations
(Item 7)
No
questions or deputations were received.
22
Joint Work on Obesity
(Item 8)
Julie
Billett and Jeanelle De Gruchy introduced the report and presented
on a cross-borough approach to tackling obesity. It was proposed
that the Joint Sub-Committee agree to six pledges to improve
healthy food choices in Islington and Haringey, and that Islington
and Haringey Councils sign up to the Local Government Declaration
on Sugar Reduction and Healthier Food.
The
following main points were noted in the discussion:
-
It was queried if the removal of sugar sweetened
soft drinks could have unintended consequences, for example an
increase in the sale of sugar-rich fruit juices and unhealthy
‘zero calorie’ beverages. In response, it was advised
that consideration was needed to ensure that messages around the
health benefits of fruit were consistent with messages around
reducing sugar consumption.
-
Dentists were particularly concerned about dental
decay in children and this was attributed to the consumption of
sugar-rich food and drink, including fruit.
-
It was suggested that further work was needed on
communicating the benefits of avoiding sugar.
-
A discussion was had on how sugary food and drink is
advertised to children, particularly through the use of brand
characters. Children felt an attachment to certain products and
brands because they were advertised in a “fun”
way.
-
Work was needed to address the idea of home cooked
food always being a healthier option, as home cooked food could
contain high amounts of sugar and fat.
-
It was suggested that communications on sugar
reduction should be customised for different ethnic and cultural
groups, otherwise key messages may only reach a narrow section of
the population and health inequalities may be enhanced,
particularly among non-English speakers.
-
The Sub-Committee considered the difficulties of
encouraging local business to reduce the supply of sugar-rich food
and drink. It was noted that there was a high profit margin on
these items and several small businesses were struggling in the
difficult economic climate. In response, there was an appreciation
of these challenges, and it was also noted that the greatest impact
would potentially be realised through a focus on major
retailers.
-
It was suggested that communications on reducing
sugar consumption and healthier eating should be also related to
communications on physical activity, including sustainable
transport options such as walking and cycling.
RESOLVED:
(i)
That the Haringey and Islington Health and Wellbeing
Boards Joint Sub-Committee agree to the pledges set out in the
report submitted;
(ii)
That Islington and Haringey councils sign up to the
Local Government Declaration on Sugar Reduction and Healthier
Food.
23
STP Update (Item 9)
Tony
Hoolaghan introduced the report and presented on the progress of
the North Central London Sustainability and Transformation Plan
(NCL STP).
The
following main points were noted in the discussion:
-
The NCL STP was transitioning to the implementation
phase. It was intended for some joint acute commissioning to be
carried out across North Central London in the near
future.
-
A new CCG leadership team had been appointed across
Haringey and Islington.
-
NCL STP arrangements had been subject to scrutiny at
a local level and at the NCL Joint Health Overview and Scrutiny
Committee.
-
The STP was a complex and ambitious plan and
capacity was needed to deliver the work identified in the plan. It
was intended for the STP to enhance prevention, primary care, and
community resilience, however, capacity to deliver the ambitious
plans set out in the STP will be drawn largely from within existing
resources and capacity.
-
In response to a question on voluntary sector
engagement, it was advised that engagement with the sector had
increased as the STP process had developed.
-
A member queried how hospital discharge could be
improved through the STP. In response, it was advised that national
guidance would be followed and patients would be categorised into
streams. Work was in progress for patients to be dealt with in a
consistent way across Islington and Haringey. Once a patient had
been admitted to hospital, it was intended for the patient to be
safely discharged as soon as possible.
-
It was commented that those with complex care needs
were best assessed in their normal place of residence, as those in
need of care may have different capabilities in different
environments.
-
A discussion was had on hospital discharge
arrangements. It was emphasised that hospital discharge should only
occur when the patient is able to care for themselves independently
or with appropriate support. It was commented, for example, that
the discharge of patients with mental health conditions should not
take place while patients are still vulnerable.
-
The Sub-Committee noted the work of the National
Housing Federation, which was working with housing providers to
support hospital discharge. It was suggested that housing officers
should be contacted at the point of admission so bespoke
arrangements can be made, if required.
-
The Sub-Committee considered examples of patients
who did not require acute care, however were returning home to a
hazardous environment. It was considered that engagement with
housing providers was essential to ensure that vulnerable patients
were appropriately supported.
-
In Haringey, multi-disciplinary team conferences
were held weekly, which considered the needs of vulnerable patients
planned for discharge.
-
The Sub-Committee noted concerns about the STP
process, and on the financial pressures of public bodies. Whilst it
was welcomed that progress had been made, it was commented that
honest conversations were needed between partner bodies about how
services can improve and work closer together within existing
resources. It was suggested that the STP needed a stronger focus on
social care services and would benefit from a more system-wide
approach.
-
The importance of public consultation was
emphasised. It was commented that engagement with the public must
be pitched appropriately.
-
The Sub-Committee noted concerns that the need for
financial savings was driving short-term approaches rather than
long-term solutions in the health and care sector. It was important
to ensure that the needs of all STP partners were appreciated and
system-wide solutions were found, otherwise positive work to
improve services and make savings could be undermined.
-
It was suggested that STP processes had previously
delayed meaningful conversations taking place, however it was
thought that there would be opportunities for all partners to
contribute to the STP in the near future.
RESOLVED:
That
the report be noted.
24
Wellbeing Partnership Programme Update
(Item 10)
Rachel
Lissauer, Director of the Haringey and Islington Wellbeing
Partnership, introduced the report.
The
following main points were noted in the discussion:
-
The Wellbeing Partnership was recognised within the
NCL STP as a positive example of cross-borough partnership
work.
-
Work was underway to develop working arrangements
across organisations and foster a more collaborative
approach.
-
Governance structures had been re-shaped to
streamline decision-making. Following this preliminary work, there
was a need for the Partnership to deliver real change.
-
The Partnership was focusing on improving hospital
flows, simplifying discharge processes, and reducing the length of
admission for patients. It was previously the case that hospitals
serving both boroughs had to work with separate discharge and
intermediate care arrangements, however there was now a single
process in place.
-
Future work would focus on recruitment, workforce
development, and estates strategies.
-
It was queried what differences patients were
experiencing in health and care services. In response, it was
advised that a number of improvements were in progress, for example
the availability of physiotherapy in GP surgeries. In other cases,
efficiency savings would improve sustainability and protect
existing services.
-
It was commented that trust had developed between
partner organisations and as a result positive conversations were
taking place. It was thought that a more collaborative approach
would improve clinical pathways and lead to a more positive patient
experience.
-
Whilst the positive work of the Wellbeing
Partnership was recognised, it was suggested that further work was
needed to demonstrate and communicate that the Partnership was
making a tangible difference.
RESOLVED:
That
the report be noted.
25
Joint JSNA Update (Item 11)
Julie
Billett and Jeanelle De Gruchy introduced the report and presented
on progress with developing a cross-borough Joint Strategic Needs
Assessment.
The
following main points were noted in the discussion:
-
There would be practical benefits to having a joined
up health analytics and intelligence function. It was suggested
that this would help to determine how cross-borough services were
commissioned and delivered.
-
It was noted that the full JSNA would include a
detailed population analysis, and would reflect the number of
residents suffering from multiple disadvantages.
-
The Sub-Committee emphasised the importance of a
joint narrative to accompany the raw data.
-
The Sub-Committee noted the importance of equalities
data, and noted the importance of ensuring the needs of different
communities are understood and described, in order to help shape
services to better meet those needs and reduce
inequalities.
RESOLVED:
That
the report be noted.
26
Mayor's Health Inequalities Strategy
(Item 12)
Julie
Billett introduced the Mayor’s Health Inequalities Strategy.
The Mayor of London was seeking partner organisations to endorse
and contribute to the strategy’s five aims. It was proposed
that a joint Islington and Haringey response be submitted to the
strategy consultation.
The
Sub-Committee endorsed the strategy and agreed to submit a joint
response, however emphasised that the GLA also had responsibilities
and powers which influenced the health of local people. For
example, the GLA had influence over air quality through public
transport emissions and the regulation of taxis and other
vehicles.
It was
suggested that the strategy’s objectives could be more
specific, and strengthening the objectives was more likely to
result in meaningful change.
RESOLVED:
That
the development of a joint Islington-Haringey response to the
consultation be endorsed.
27
New Items of
Urgent Business (Item 13)
None.
The
meeting ended at 3.15 pm
Chair